Active NPI
Noelle Mortensen Haines, A.P.R.N FNP-BC
- Family Nurse Practitioner
- Salt Lake City, UT
National Provider Identifier
1285214205
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 10216868-4405
- Practice address
- 2796 S 2000 E
Salt Lake City, UT 84109-1737 - Phone
- (301) 693-7830
- NPI assigned
- Apr 13, 2021
- Last updated
- Jul 14, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 10216868-4405 | UT | Primary |
Addresses
Primary practice location
2796 S 2000 E
Salt Lake City, UT 84109-1737
Mailing address
12433 S Fort St
Draper, UT 84020-9363
Phone (801) 576-1086
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10216868-4405 | UT | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Amazing Medical Associates, Inc | Current | Accepting new patients | |
| Patients Choice Providers of Utah LLC | Current | Accepting new patients | |
| Pioneer Injury Care | Past | Accepting new patients | |
| Pioneer Comprehensive Medical LLC | Family | Past | Accepting new patients |
Locations
434 W Ascension Way
Ste 225
Salt Lake City, UT 84123
Phone (801) 716-7008
Interoperability endpoints
- noelle.haines@736943059828740.direct.elationemr.com
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba AMG Senior Medical Group
- Multi-Specialty Clinic/Center
- Murray, UT
- NPI 1487836532
-
dba Patients Choice Providers
- Geriatric Medicine (Family Medicine) Physician
- Pleasant Grove, UT
- NPI 1497595011
-
- Family Medicine Physician
- Draper, UT
- NPI 1891975595
-
- Nurse Practitioner
- Draper, UT
- NPI 1114382033
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783987200000",
"number": "1285214205",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12433 S FORT ST",
"city": "DRAPER",
"state": "UT",
"postal_code": "840209363",
"telephone_number": "801-576-1086",
"fax_number": "801-576-9796"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2796 S 2000 E",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841091737",
"telephone_number": "301-693-7830"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAINES",
"first_name": "NOELLE",
"middle_name": "MORTENSEN",
"credential": "A.P.R.N FNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-04-13",
"last_updated": "2026-07-14",
"certification_date": "2026-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "UT",
"license": "10216868-4405",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.